The Current - How to get patients moving? Walk with them, this doctor says

Episode Date: March 20, 2025

Ohio doctor David Sabgir realized that asking his patients to get out and exercise wasn't working. So, he strapped on his running shoes and hit the pavement with them. The program, called Walk With A Doc, has spread to more than 500 communities around the globe in the 20 years since. Dr. Sabgir explains the difference walking has made for his patients — and his own practice.

What do you see when you look around? Lively cities, growing neighborhoods, things that connect us. For those into skilled trades, it's a world they helped create. Discover more than 300 careers, paid apprenticeships, and the unmatched feeling of saying, I made that. Learn more at Canada.ca slash skilled trades. A message from the government of Canada. This is a CBC podcast.

Hello, I'm Matt Galloway and this is the current podcast. There are six pillars within lifestyle medicine that influence our health. Do you guys have any guesses of what they are? What could these lifestyle interventions be? I would say one would be connections. Like social connections? To Saturday morning health quiz at an Oakville community center.

Nature, so nature's I would say a bonus pillar. I don't know, I don't know. That's good. Sleep learning. Sleep learning. Yeah, sleep is very important. About two dozen people of all ages are gathered around Dr. Niveda Patel. She has traded in her lab coat for a t-shirt and running shoes as she talks to an eager

audience. This is a regular get-together called Walk with a Doc. Folks of all fitness levels gather for a physician led discussion before getting their steps in. I like the fact that we have this short talk by the doc. They explain the benefits of holistic health. I think it's a good reminder. You know it, you know these things, but I think it's just uncovering those layers

and having that reminder constantly that you need to give priority to your health. I think that has been very beneficial. I draw inspiration. I think I just like the mix of the ages in this group because we have like children coming sometimes, still seniors. So when I look at that, it just motivates me tremendously.

Walk with a Doc is the idea of Ohio cardiologist, David Sabger. We're coming up to the 20th anniversary of this project. It's now spread to more than 500 communities and 30 countries around the globe, including of course right here in Canada. And Dr. Sabger joins us from New Albany, Ohio. Dr. Good morning.

Good morning, Matt. Thank you for having me. It's really great to have you here. This is such a neat idea. How does it feel for you to hear one of the sessions from this idea that you created underway in a different country. Yeah, I was smiling all through that.

I love seeing that this need for being together and physical activity is universal, and it really warms my heart to hear that clip. So go back to a 20 years younger Dr. Sabger. How did this idea start? Where did it come from? Yes, please call me David. I, you know, as you know, Matt, exercise,

just regular physical activity is truly the fountain of youth and through med school, residency training and cardiology would have thousands of conversations that really felt like I was connecting at the time. But when the patient came back for six or 12 month follow-up, it took me too long to realize that I was really ineffective at inspiring this patient to be active. I was failing so I did not want to look at the next 30-35 years hopefully of my career having these charades of conversations and I really felt we needed to do something more so my wife and I would go to the park on weekends with our kids

and I just invited a patient to go and that's when this whole magical ride started. You invited a patient just to go for a walk with your family? Yes. What did your wife think of that? I mean, you're not working and so going out to the park with What did your wife think of that? I mean, you're not working, and so going out to the park with your family is kind of your own time. Yeah, my wife is fantastic.

She's been a wonderful partner through all of this over the last 20 years. So she also, she loves to participate in exercise, sees the need and has been along for the ride. Can I ask you, I wanna talk about how this works, but you've said a couple of things already that I think are really interesting. One is that you felt like you were failing

in terms of getting your patients to be more physically active. Why would you use that word failing? What were you asking them to do and what weren't they doing? Yeah, thank you for that. In Ohio, the sedentary and obesity rate, the obesity rate is 70% nationally in the US and sedentary rate is even higher.

So we need to be active as a people and just regular moderate physical activity has miraculous benefits. So when these patients that I care deeply about their health, when they came back and it wasn't working, I was failing to inspire them to just adopt these lifestyle habits that not only are physically amazing on so many levels, but also mentally and emotionally with all the news that we're hearing,

it's so great to get out and just clear our mind for a few minutes. You use the word charades to describe the kind of interaction that you would have with your patients as you would say, you should get out and be more physically active. Why would you use that word in particular? Yeah, it just, it wasn't working.

We, it was a charade that I was thinking that I was being effective. After we talked about blood pressure, cholesterol, their stent, their bypass surgery. It was really important to I love to rip the weed out at the root and get at the, the issue. And these conversations were great, Matt, you know, I, I connected, I, I would write an asterisk on the chart. Like I can't wait to see the progress in Susie when she comes back.

And one after the other after the other, it just wasn't working. And we needed to do something else. So on that first walk, when you said to the patient, why don't you just come out to the park with me and my family? What happened then? So we were very fortunate,

as we've seen with all our amazing doctors around the world that are leading the program. There's a huge need, both from the patients and from us, the healthcare providers. So we collected, we realized we stumbled on something magical that day. The response was out of this world with between my teammates in the office

and community partners. So we realized we had to kind of get our ducks in a row. And we then collected about a thousand emails from the next six months of patients and people that were interested. We had our first walk April 9th of 2005 and we had over a hundred people there and we've just been off to the races ever since. What happens?

I mean you get people together and you go for a walk. How far do you walk? Yeah, so the anatomy is fun. We try and keep it simple and sustainable for all our healthcare providers that want to do that. Just as you heard in the clip, we start with a three, five minute talk about anything that people would like to talk about. We're more than happy to take requests on anything. Tomorrow we're going to be talking about palpitations. And then this really brings about the social connection,

one of our pillars, us being all together. It breaks the ice, breaks down the barriers, which is what we are trying to do at Walk with a Doc. And then everyone walks at their own pace, their own distance. We don't want people feeling they're having to walk too far, too fast or too slow. We want them to come back and experience the health of walk with a doc. What do you see when you look around?

You see when you look around. Lively cities, growing neighborhoods, things that connect us. For those in the skilled trades, it's a world they helped create. Discover more than 300 careers, paid apprenticeships, and the unmatched feeling of saying, I made that. Learn more at Canada.ca slash skilled trades. A message from the Government of Canada. In Scarborough, this is fire behind our eyes. A passion in our bellies. It's in the hearts of our neighbors.

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Donate at lovescarborough.ca. I mean, it's not just walking. One of the things that happens when you go for a walk with people is you end up talking about things too. The doctors that I know, because of the nature of their profession, everywhere they go, once they reveal that they are a doctor, somebody will ask them something about their profession and ask them questions that they would want answered from a doctor. What are the conversations that you have when you're out?

The conversations are wonderful and they can just run the gamut with everything. And you're out? The conversations are wonderful and they can just run the gamut with everything and you're right the social connection is is so powerful but we will talk about blood pressure, cholesterol, coronavirus, but we'll also talk about upcoming vacations and you know a granddaughter's birthday. Anything that they want to talk about we've seen now more and more in the last two to three years the data supporting social connection is incredible. It reduces hospital admissions, reduces death, reduces pneumonia, all these things you wouldn't

think about. So that's one of our pillars of why we're all there. And you're right, it's more than just walking. What is the appeal for doctors like yourself to be part of something like this? It's paying down on principle and not interest. It's the opportunity for us to connect in nature away from the bureaucracy. Our doctors are forming long-lasting, if not lifetime, friendships with their community members. I'm not sure that this doesn't benefit us as physicians more than our guests. But your guests, the people that you're walking with,

your patients, they also would see something that comes out of this. What sort of changes have you seen in the people who go walking with you? We've seen so many cool things. So our pillars are physical activity, social connection, nature, and education. And just a couple of those, we had an amazing geneticist

who even after the years she spent with us walking, she was then confined to a wheelchair, but would still on frigid days drive across the city just to sit next to the picnic table in the pavilion, all bundled up, talking to everyone. So we've seen that's so important. We've seen, of course, incredible weight loss over the years. We're blessed to have so many guests over the years that we'll see that. And then there's things that we don't see. Walking can reduce Alzheimer's by 50%.

So we know with hundreds of thousands of guests around the world that we're also fortunate to not only avoid the heart attacks and strokes and reduce anxiety and depression, but also cut Alzheimer's in half. So wonderful, far-reaching physical benefits. and it's been an absolute joy ride. So you've actually seen, I mean, you talked earlier about the charade. You've actually seen a change, a measurable change in some of the people who come out

that perhaps you would not have been able to achieve in those other conversations that you were having in the office that let you believe that you were failing. We have, we have, and I think that's not only important to me, but important to all of our healthcare providers around the world is we need that visceral feedback. You've heard certainly about the physician burnout rates being high. This program, Walk with a Doc, reminds us of why we went into medicine. And, you know, Matt, I can't remember a Saturday where I've left the park and not been in a

great mood. And our goal at Walk with a Doc is to get this to as many providers as possible so they get the benefit. And of course, we've seen it transform communities around the world. And we are just really bent on making this happen for anyone who wants to do it. I mean, one of the things is that in this country particularly, and I'm sure elsewhere, there is a real crisis in terms of a shortage of family physicians, people going into family medicine and primary care in particular.

And so there are a lot of people who can't get a family doctor, but the doctors who are working are overworked. You mentioned burnout. They're shortening people's appointment times because they need to cram more people into the schedule. How can doctors fit something like this in? How do you go about convincing them that this is a valuable use of their shrinking time? Yeah. It's counterintuitive, right, Matt?

Just as you say, what I have felt over the last 20 years is 10X. I feel like I get 10 times back the effort that I put into the lock, and our team makes it very easy to get it started. But it again, it reminds us of why we went into medicine. And you know, we've been, you mentioned family practitioners and I figured at the start we would have primary care docs and that would be it. We've been amazed and so fortunate to have hundreds and thousands of plastic surgeons and pathologists, radiologists, specialties we never would have expected. Just that one hour of time at the park can rejuvenate you for the whole week. Plus, when you're in the office Monday through Friday, at the close

of every visit, for just five seconds, you can invite that patient to join you and walk with a doc, and that adds a whole nother dimension of caring that I believe, and our incredible physicians believe is needed. How has this changed how you think about motivating your patients? I mean, not everybody can come on the walk with a doc, but as you said, you're trying to get people to be active, particularly at a time when obesity rates are through the roof.

So how has this changed the advice and the prescriptive nature of you delivering that advice to your patients? I feel so much more confident. Not only, you know, initially, Matt, I would talk about what's your favorite physical activity. Okay, great. Hop on the elliptical or then that wasn't working and started writing prescriptions for exercise. That didn't work for us. So we realized we just need to do more and we have found that this can really make a difference. And even if that patient does not join us at the park on Saturday, they may say, hey, I'm not going to drive 20 odd miles to go walk with him, but I can just throw on my shoes and by the time I walk 20 minutes, I would have arrived at the park and I'll just get

it done here. So hopefully the commitment of our volunteer physicians around the world to do this speaks to the importance of the miracle of physical activity. Make the pitch just finally, you've hinted at that, but make the pitch to people who may not have the opportunity to walk with a doc But they know they know they need to get out more they know they need to be more active and life is life And it's busy and there's a lot of things going on and the weather's been lousy and maybe they don't want to go outside What would you say to them?

Just to go small baby steps Even if it's putting on your sneakers and not going outside. But find a way to be active if you can, not only to prevent a heart attack X years down the road, but to give yourself a happier life. It increases our self-esteem. So we are around for our loved ones, It makes us, so we are around for our loved ones, emotionally, physically, spiritually, and just start small. You don't need to build Rome in a day. Just go for a little bit, and I guarantee the next day

you'll wanna do it again, if not a little more, and that's how all great habits start. And how this thing started, with one little thing, and then suddenly there's people all around the world who are doing this. We're so lucky, and we're very happy to have 590 chapters, but we're not content. We need thousands and would love to have

as many as possible in Canada and would personally love to make that happen. So if anyone's interested, we have ways to make it happen. What a great idea and I'd love to see how it's taken off. David, it's really good to talk to you about this. Thank you very much. Matt, it's an honor. I'm a fan. Thank you. Dr. Davis Abger is a cardiologist and founder of Walk with a Doc. We reached him in New Albany, Ohio. If you are looking for more information, just Google Walk with a Doc and

the program might be in your area.